Dodavanje progesterona tijekom prijenosa svježih i zamrznutih embrija

master's thesis

• Title (english): Addition of progesterone during fresh and frozen embryo transfer
• Author: Rahela Šafarić
• Mentor: Dinka Pavičić Baldani (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Progesteron je ključan hormon za prijelaz endometrija iz proliferativne u sekretornu fazu, što je vitalno za implantaciju embrija i održavanje trudnoće. Ovaj hormon regulira menstrualni ciklus, mijenja cervikalnu sluz i sprječava kontrakcije mišića maternice. Progesteron se sintetizira iz kolesterola u jajnicima, nadbubrežnim žlijezdama i mozgu, pri čemu se kolesterol pretvara u pregnenolon, a potom u progesteron. Medicinski pomognuta oplodnja (MPO) obuhvaća metode kao što su intrauterina inseminacija (IUI), izvantjelesna oplodnja (IVF), intracitoplazmatska injekcija spermija (ICSI), embriotransfer prethodno zamrznutih embrija (FET), donaciju gameta, predimplantacijsko genetičko testiranje (PGT), pomognuto izlijeganje (AH), očuvanje plodnosti i surogatstvo. Embriji se prenose u maternicu s pomoću katetera nakon kultivacije, a kvaliteta prijenosa može se poboljšati pravilnim rukovanjem embrijima i minimiziranjem izloženosti nepovoljnim uvjetima. Nakon prijenosa embrija, podrška lutealnoj fazi ključna je za održavanje funkcije žutog tijela i uspješnu implantaciju, što se postiže primjenom progesterona ili ponovljenim injekcijama hCG-a. Dodatak progesterona značajno poboljšava ishod trudnoće kod prijenosa svježih i zamrznutih embrija. Krioprezervacija embrija uključuje metode poput sporog zamrzavanja i vitrifikacije, koje sprječavaju formiranje kristala leda i toksičnih koncentracija otopina. U prirodnim i modificiranim prirodnim ciklusima FET-a (dodavanje progesterona može smanjiti kontraktilnost maternice, potaknuti imunološke prilagodbe i poboljšati uvjete za implantaciju embrija. Sve ove metode i postupci imaju za cilj poboljšanje stope uspješnosti trudnoće, uz posebnu pažnju na pravilno vrijeme i način primjene progesterona kako bi se osigurao optimalan ishod prijenosa embrija.

Abstract (english)

Progesterone is a key hormone for transitioning the endometrium from the proliferative to the secretory phase, which is vital for embryo implantation and the maintenance of pregnancy. This hormone regulates the menstrual cycle, alters the cervical mucus, and prevents uterine muscle contractions. Progesterone is produced from cholesterol in the ovaries, adrenal glands, and brain, where cholesterol is converted into pregnenolone and then into progesterone. Medically assisted reproduction (MAR) includes methods such as ovulation induction, intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), frozen embryo transfer (FET), gamete donation, preimplantation genetic testing (PGT), assisted hatching (AH), fertility preservation and surrogacy. After the embryos have been cultivated, they are transferred into the uterus using a catheter. The quality of the transfer can be enhanced by ensuring proper handling of the embryos and minimizing exposure to unfavorable conditions. Following the embryo transfer, it's essential to provide luteal phase support to maintain corpus luteum function and facilitate successful implantation. This can be achieved through the administration of progesterone or repeated hCG injections. Progesterone supplementation significantly improves pregnancy outcomes in both fresh and frozen embryo transfers. Embryo cryopreservation includes methods like slow freezing and vitrification, which prevent the formation of ice crystals and toxic concentrations of solutions. In natural and modified natural cycles of FET adding progesterone can reduce uterine contractility, promote immunological adaptations, and improve conditions for embryo implantation. All these methods and procedures aim to improve pregnancy success rates, with special attention to the proper timing and method of progesterone administration to ensure optimal embryo transfer outcomes.

• Keywords: progesteron; izvantjelesna oplodnja ( IVF); prijenos embrija
• Keywords (english): progesterone; in vitro fertilization (IVF); embryo transfer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:708349
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-29 15:59:14